Prevent Readmissions With Nurse Intervention

Rebecca Hendren, for HealthLeaders Media , September 27, 2011

The nurses found that talking with patients and their families improved their understanding of their medication regimen and increased compliance. But the nurses struggled with patients discontinuing medications because of side effects.

The study “confirmed that if they felt a med was not helping them or made them feel worse, they stopped taking it,” Costa says. “How they identified which medication was random. It could be a blood pressure pill or a blood thinner pill. They would select one or two and they would stop taking them if they felt it was affecting them. It wasn’t related to particular side effects and it was pretty random as to which one they didn’t take.”

In some cases, the most important nurse intervention was counseling patients to tell their doctors that they were not taking or had problems with particular medications.

Costa ran the pilot study on a small budget and hopes to examine the larger implications of the findings with further research. She says the initial results indicate that home visits provide a good return on investment.

“If you look at the costs that hospitals will spend to reduce readmissions, the cost of this program is not that significant,” she says. “We’re seeing patients in our local area, so it’s feasible to do. There is value to be had and I don’t think it’s exceedingly costly.” 

Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits and manages The Leaders' Lounge blog for nurse managers. Email her at
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3 comments on "Prevent Readmissions With Nurse Intervention"

Amy (12/11/2011 at 6:38 PM)
It's great to see this article. I've worked in both the hospital and home setting as a nurse for about 10 years now. I've seen first hand what can happen between the hospital discharge to home. It's been sometimes amazing what you might find once you go into a home. Medications is definitely a big one and many times is related more to understanding rather than financial. I've been fortunate to learn a lot from working in both areas and try to incorporate what I've learned in my everyday practice whether in the hospital or the home.

Matt (9/30/2011 at 11:06 AM)
Did the study have an ROI? Or was it just money spent to reduce readmissions? Is it feasible fiscally to have nurses that make home visits? APNs or RNs?

Naomi Ervin (9/30/2011 at 10:51 AM)
It is great to see that home health care nursing has been re-discovered. This type of nursing service has been available for over 100 year. Numerous studies have demonstrated the effectiveness for early discharge and preventing re-admissions.




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